SURGICAL LAPAROSCOPY WITH INTRAOPERATIVE MANOMETRY IN THE TREATMENT OF ESOPHAGEAL ACHALASIA

The aim of this study was to describe and evaluate the laparoscopic tr eatment of esophageal achalasia in nine patients over a 35-month perio d. Five trocars were used to perform a Heller's myotomy to completely eliminate the cardial high-pressure zone, under manometric control. In traoperative manometry also was used to calibrate a pick degrees 360 R ossetti's antireflux wrap. A complete regression of symptoms was obser ved postoperatively in seven of nine patients (77.8%); in two patients (22.2%) a moderate dysphagia persisted, but it disappeared 3 and 6 mo nths, respectively. Only one intraoperative complication (esophageal p erforation, recognized and laparoscopically repaired) occurred. At the present follow-up of 18 +/- 5.34 months (range 6-35), no dysphagia or symptoms related to reflux have been observed. Laparoscopic treatment of esophageal achalasia is considered a safe and effective procedure, and the results of this procedure are comparable with those of the op en technique. Advantages common to other laparoscopic techniques are e mphasized.